Measurements and detection of abdominal aortic aneurysm growth: Accuracy and reproducibility of a segmentation software

Kauffmann, Claude; Tang, An; Thérasse, Éric; Giroux, Marie‐France; Elkouri, Stéphane; Melanson, Philippe; Melanson, Bertrand; Oliva, Vincent L.; Soulez, Gilles

doi:10.1016/j.ejrad.2011.04.044

Cited by 75 publications

(59 citation statements)

References 25 publications

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“…In addition, because a volume measurement reflects the aneurysm in a 3D way, it can overcome the issues associated with measuring the cross-sectional diameter in tortuous aortas. 28 The aneurysm volume is usually assessed by CT scanning and automatic segmentation software programs, 29 which is not cost-effective for the follow-up of aneurysms without surgical indication. The development of matrix probes with novel electronic arrays made 3D-US reliable for aneurysm volume calculation.…”

Section: Discussionmentioning

confidence: 99%

Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm

et al. 2016

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The objective was to demonstrate the ability of ultrasound (US) with 3D properties to evaluate volumetry and biomechanical parameters of the aorta in patients with and without abdominal aortic aneurysm (AAA). Thirty-one patients with normal aortas (group 1), 46 patients with AAA measuring 3.0-5.5 cm (group 2) and 31 patients with AAA ⩾ 5.5 cm (group 3) underwent a 2D/3D-US examination of the infra-renal aorta, and the images were post-processed prior to being analyzed. In the maximum diameter, the global circumferential strain and the global maximum rotation assessed by 2D speckle-tracking algorithms were compared among the three groups. The volumetry data obtained using 3D-US from 40 AAA patients were compared with the volumetry data obtained by a contemporary computed tomography (CT) scan. The median global circumferential strain was 2.0% (interquartile range (IR): 1.0-3.0), 1.0% (IR: 1.0-2.0) and 1.0% (IR: 1.0-1.75) in groups 1, 2 and 3, respectively (p < 0.001). The median global maximum rotation decreased progressively from group 1 to group 3 (1.38º (IR: 0.77-2.13), 0.80º (IR: 0.57-1.0) and 0.50º (IR: 0.31-0.75), p < 0.001). AAA volume estimations by 3D-US correlated well with CT (R 2 = 0.76). In conclusion, US with 3D properties is non-invasive and has the potential to evaluate volumetry and biomechanical characteristics of AAA.

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Section: Discussionmentioning

confidence: 99%

Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm

et al. 2016

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“…This increased longevity has shown that aortic complications are not limited to the aortic root and can occur throughout the entire aorta (7). Therefore, visualization of the total aorta by means of magnetic resonance (MR) imaging or computed tomography (CT) at regular intervals is recommended (8). However, complications in the aortic trajectory beyond the aortic root are difficult to foresee by measuring aortic diameters (9).…”

Section: Study Subjectsmentioning

confidence: 99%

Aortic Disease in Patients with Marfan Syndrome: Aortic Volume Assessment for Surveillance

Hartog¹,

Franken²,

Witte³

et al. 2013

Radiology

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Purpose:To assess the reproducibility of aortic volume estimates and to serially test their use in patients with Marfan syndrome. Materials and Methods:The study was approved by the medical ethics committee and all subjects gave written informed consent. In 81 patients with Marfan syndrome and seven healthy control subjects, aortic volumes and diameters at baseline were estimated by means of contrast material-enhanced magnetic resonance (MR) imaging. At 3 years of follow-up, aortic expansion rate were calculated in a subgroup of 22 patients with Marfan syndrome. Total aortic volume was defined as volume measurement from the level of the aortic annulus to the aortic bifurcation. Intra-and interobserver agreement of aortic volume were calculated by using the intraclass correlation coefficient. Differences in variables were analyzed with the Student t test and logistic regression. Effect size was calculated. Results:Intra-and interobserver agreement of aortic volume calculation was 0.996 and 0.980, respectively. Mean aortic volume was significantly greater in patients with Marfan syndrome than in control subjects (104 mL/m 2 ; 95% confidence interval [CI]: 95, 114 mL/m 2 vs 74 mL/m 2 ; 95% CI: 62, 87 mL/m 2 ; P , .001). In 22 patients with Marfan syndrome, mean aortic volume was increased at 3 years of follow-up (17 mL; 95% CI: 8, 26 mL; P = .001; effect size, 0.29), while mean aortic diameter did not increase significantly (0.4 mm; 95% CI: 0.0, 0.9 mm; P = .171; effect size, 0.13). Conclusion:Assessment of aortic volume is highly reproducible and may be suited for use in the detection of aortic expansion in patients with Marfan syndrome.q RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup /suppl

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“…Modern computed tomography (CT) and magnetic resonance imaging (MRI) with advanced image processing methods, such as multiplanar reformation, are perceived to have higher accuracy and reproducibility, with a reported intra-and interobserver variability of <2 mm. 6 Although CT or MRI is frequently the preferred imaging modalities for monitoring growth rates in small clinical trials, they are less suitable for mass screening and large-scale trials. Similar reproducibility for ultrasound and CT has been reported in some but not in all studies when a standardized protocol is used.…”

Section: Aaa Diametermentioning

confidence: 99%

“…28 There has been considerable progress in segmentation software, allowing a rapid semiautomatic or even completely automatic calculation of accurate volumes. 6 Surveillance after endovascular aortic repair by CT or ultrasound is recommended by current guidelines. 2 Continued sac expansion is suggestive of an endoleak and an important risk factor for secondary aneurysm rupture.…”

Section: Aaa Volumementioning

confidence: 99%

“…9 It has been suggested that diameters measured perpendicular to the aorta centerline (orthogonal), rather than within the axial plane, are more representative of the true AAA diameter. 4,6 With ultrasound, measurements within the anteroposterior, rather than the transverse plane, have been reported to be more reproducible. 4 There is no current consensus on how to place the calipers when measuring the diameter with ultrasound.…”

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confidence: 99%

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Surrogate Markers of Abdominal Aortic Aneurysm Progression

Wanhainen

Mani

Golledge

2016

ATVB

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Abstract-The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Wanhainen et al Surrogate Markers of Aneurysm Progression 237in all studies when a standardized protocol is used. 7,8 One of the challenging aspects to assessing maximum AAA diameter is the variety of methods that can potentially be used and the lack of reporting of the exact techniques used in individual studies. Variations may occur in the plane of acquisition (eg, coronal or sagittal), the axis of measurement (eg, axial or orthogonal), the position of the measuring calipers (eg, inner to inner or outer to outer), the relationship with the cardiac cycle (systole versus diastole), and the selected region of the AAA. 9 It has been suggested that diameters measured perpendicular to the aorta centerline (orthogonal), rather than within the axial plane, are more representative of the true AAA diameter. 4,6 With ultrasound, measurements within the anteroposterior, rather than the transverse plane, have been reported to be more reproducible. 4 There is no current consensus on how to place the calipers when measuring the diameter with ultrasound. Methods used include the outer-to-outer method, where calipers are placed on the outer layer of the aortic wall; the inner-to-inner method, where calipers are placed on the inner layer of the aortic wall; and the leading edge-to-leading edge method, where calipers are placed on the outer layer of the anterior wall and the inner layer of the posterior wall ( Figure 1). Much of the reported variation in ultrasound measured AAA diameter is likely because of the variation in caliper placement. 5,10 The UK Small Aneurysm Trial 11 is based on the measurement of AAA diameter on the outer-to-outer method, and this method has been adopted into the current UK intervention criteria. 12 The inner-to-inner method was used in the Multicentre Aneurysm Screening Study, 13 and consequently it is used in the current UK National Health Service AAA screening programme.14 The leading edgeto-leading edge method is used in the current Swedish AAA screening programme.15 Studies comparing these methods show there is a significant difference in diameters measured with the different methods, which has an impact on the reported prevalence rates of AAA. 5,10 In a Swedish AAA screening study, the difference in mean diameter was 4 mm between inner-toinner and outer-to-outer, which resulted in an astonishing 77% difference in AAA prevalence (ie, 1.3% compared with 2.3%). 5A systematic review of 15 studies reported considerable variation in small AAA growth rates (mean, −0.3 to +4.0 mm/y). 15 The variation could not be explained by differences in initial AAA diameter alone. 16 The authors suggested that methodological issues, such as differences in imaging modalities, variation ...

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Measurements and detection of abdominal aortic aneurysm growth: Accuracy and reproducibility of a segmentation software

Cited by 75 publications

References 25 publications

Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm

Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm

Aortic Disease in Patients with Marfan Syndrome: Aortic Volume Assessment for Surveillance

Surrogate Markers of Abdominal Aortic Aneurysm Progression

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